Practice Tips #75: Clean Before You Sterilize

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This latest issue of Practice Tips is on infection control. According to CDC guidelines, in order for an item to be sterilized, it must first be “clean.” What exactly does “clean” mean? Once again, according to the CDC an item must be “free of gross debris” to be considered clean. That’s it.

How can you clean your instruments?

First, consult the instructions provided with your instruments. Many of them have specific guidelines as to how to clean them or particular chemicals to avoid. In general, you should try to avoid harsh chemicals whenever possible, this includes all disinfectants. As long as the item in question can be sterilized (i.e. is resistant to heat), there is NO NEED to disinfect. The only purpose of disinfection is to kill bacteria that may be present, if an item is NOT sterilized. Look at the chart from the ADA in regards to the levels of sterilizing and disinfecting:

If an item cannot be sterilized (it is not made of materials that will withstand the heat, pressure, and moisture associated with sterilization) then it may need to be disinfected. However, it is still preferable to use the “barrier method” rather than disinfecting the item in question. That is, cover the item in plastic (pouches, film, or a similar disposable barrier). Many plastic barriers are biodegradable, but the harsh chemicals that most disinfectants are composed of are not normally very environmentally friendly, so disinfection isn’t necessarily the most “green” process. More importantly, disinfectants will shorten your instrument life and bags will help protect your equipment, as well as extend the life thereof. Prolonging the life of your equipment is not only environmentally sustainable, but it will also save your practice money.

The CDC and OSHA both recommend using “mechanical means” to clean instruments whenever possible. Both the CDC and OSHA make this recommendation out of concern for the safety of staff. If some sort of machine is used to clean instruments (“…instrument washer, ultrasonic, washer disinfector, dish washer…” [page 73]), this reduces how much the instruments are handled making injury to staff less likely. The OSHA bloodborne pathogens standard also discusses the dangers of sharps injuries and should be consulted for further information on instrument handling.

Whatever method you use, make certain that your instruments are clean, dry, and free from debris before you sterilize. If using an ultrasonic cleaner, make certain to rinse any ultrasonic solution from your instruments as well as they can bake on during sterilization and cause damage to your instruments.

So remember, you need to clean BEFORE you sterilize, and disinfect only if you can’t sterilize. Try to bag them, rather than disinfect, if possible.

We hope you learned a little more about sterilization and disinfecting your dental instruments. American Dental Accessories wishes you a happy holiday and a happy new year!


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